The Application Of ADC Value And Quantitative Analysis Of DCE-MRI In The Evaluation Of Prostate Cancer Aggressiveness

Objective:To investigate the value of apparent diffusion coefficient(ADC),quantitative transfer constant(Ktrans),extracellular extracellular space volume(Ve)and rate constant(Kep)of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the evaluation of prostate cancer aggressiveness.Materials and methods:A total of 154 patients with clinically suspected prostate cancer was enrolled,MR images were acquired using GE's 3.0 T HDX TWINSP equipment and 62 patients with prostate cancer confirmed by pathology were included in this study.The shape,scope,enhancement characteristics and relationship of prostate lesions with the surrounding tissue were determined based on MR plain scan and enhanced images.The ADC plot was obtained automatically,in the GE workstation by GE Function software,and ADC value of ROIs in suspected prostae cancer were measured.The data were imported into the Omni Kinetics Manual,a dynamic enhancement analysis software developed by GE Pharmaceuticals,and Ktrans,Ve and Kep of ROIs of suspected prostate cancer were measured.All patients underwent ultrasound-guided puncture within one week after MR examination,and suspected lesions detected on MR also were punctured,besides 12 conventional puncture areas.Five groups,GS=6 points,GS = 3 + 4 points,GS = 4 + 3 points,GS = 8 points and GS=9?10 points,were divided according to the results of pathology.The ADC,Ktrans,Ve and Kep values were analyzed by single factor analysis of variance(ANOVA).Pearson correlation analysis was used to study the correlation between ADC,Ktrans,Ve,Kep values and Gleason classification.Area under the curve(AUC)was estimated by the receiver operating characteristic(ROC)curve,and prostate cancer aggressiveness was assessed by combined application of ADC values and Ktrans values.Results:With the increase of Gleason score,the ADC value decreased and Ktrans value increased,and there was statistical significance between two groups(F = 20.462,F = 13.560,P<0.05).The ADC value of prostate cancer was negatively correlated with Gleason score(R =-0.636,P<0.05),and Ktrans value was positively correlated with Gleason score(r = 0.562,P<0.05).There was no significant difference for Kep and Ve in different Gleason scores(R = 0.116,r = 0.179,P>0.05).The AUC of prostate cancer was greater with combined application of ADC value and Ktrans value than that with single use of them,in all groups,the difference was statistically significant between GS = 3 + 3 and GS ? 7,between GS ? 3+4 and GS ? 4 + 3,between GS4 + 3 and GS ? 8(P<0.05),and was not statistically significant,between GS ? 8 and GS ? 9(P>0.05).Conclusions:Both ADC and Ktrans values can be used to assess the prostate cancer aggressiveness,and the combined applicatiom of ADC and Ktrans values displays a better diagnostic performance in evaluation of prostate cancer aggressiveness.ADC values were moderately negative correlated with Gleason scores,and Ktrans values were moderately positive correlated with Gleason scores.Therefore,ADC and Ktrans values have the potential to judge the degree of malignancy of prostate cancer,help to assess prostate cancer,aggressiveness and are important for treatment planning and assessment of prognosis.